Wang Shr-Jie, Lengeler Christian, Smith Thomas A, Vounatsou Penelope, Cissé Guéladio, Diallo Diadie A, Akogbeto Martin, Mtasiwa Deo, Teklehaimanot Awash, Tanner Marcel
Swiss Tropical Institute, CH-4002 Basel, Switzerland.
Malar J. 2005 Sep 9;4:40. doi: 10.1186/1475-2875-4-40.
The rapid urban malaria appraisal (RUMA) methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology.
This work was done in Yopougon municipality (Abidjan), Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1) a literature review, 2) the collection of available health statistics, 3) a risk mapping, 4) school parasitaemia surveys, 5) health facility-based surveys and 6) a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness.
A substantial amount of literature (including unpublished theses and statistics) was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500-13,000 USD for a six to ten-week period.
RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.
快速城市疟疾评估（RUMA）方法旨在提供一种具有成本效益的工具，用于对撒哈拉以南非洲城市的疟疾情况进行快速评估，并增进对城市疟疾流行病学的了解。
这项工作在阿比让的约普贡市、科托努、达累斯萨拉姆和瓦加杜古开展。研究设计包括六个部分：1）文献综述，2）收集可用的卫生统计数据，3）风险绘图，4）学校疟疾寄生虫血症调查，5）基于医疗机构的调查，6）对医疗保健系统的简要描述。这些构成了对RUMA可行性、一致性和实用性进行多国评估的基础。
在每个地点都发现了大量文献（包括未发表的论文和统计数据），对疟疾情况提供了很好的概述。基于学校和医疗机构的调查概述了不同城市地区的当地流行情况和总体疟疾负担。这有助于确定需要深入评估的重要问题，特别是医疗机构中疟疾过度诊断的程度。绘制医疗机构和滋生地的地图可以直观呈现人口特征、卫生服务和疟疾风险之间的复杂相互作用。然而，后一项任务非常耗时，需要专业知识。RUMA成本低廉，为期六至十周的费用约为8500 - 13000美元。
RUMA在四个流行程度不同的城市地区成功实施，被证明是研究城市疟疾特征并为规划控制措施提供证据基础的一种具有成本效益的初步方法。
